The "Childmyths" blog is a spin-off of Jean Mercer's book "Thinking Critically About Child Development: Examining Myths & Misunderstandings"(Sage, 2015; third edition). The blog focuses on parsing mistaken beliefs that can influence people's decisions about childrearing-- for example, beliefs about day care, about punishment, about child psychotherapies, and about adoption.
See also http://thestudyofnonsense.blogspot.com

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Thursday, November 17, 2016

Can Brain Science Help With Practical Decisions about Child Welfare, Custody, and Treatment Issues?

In the last week or two, I’ve come across several
situations where neuroscience is referenced as helping provide understanding of
interventions for children’s mental illness or educational problems. This use
of scientific information is often called “translational” science, and it is
receiving much well-deserved attention as we try to move from laboratory
successes to practical benefits.

But, can neuroscience as it exists today tell us
anything more about how to help at-risk children than we can learn from
behavioral studies? That was the question I thought of when I read the
following:

1.A
Norwegian psychologist working with child placement decisions expressed his
concern that evidence of maltreatment is equated with brain damage and used to
argue that children should be placed in foster homes.

2.An
editorial in the Brown University Child
and Adolescent Behavior Letter was entitled “Distracted driving prevention
needs leadership from the neuroscience community” (CABL, Nov. 2016, p.8). The author very
correctly pointed out the failure of “scare tactics” to work with teenagers
with respect to drug use or criminal behavior, and expressed doubt that such an
approach would be helpful in preventing teenage distracted driving. But instead
of suggesting other well-established techniques that are known to change
behavior effectively, the author said, “what is sorely missing is the voice of
the neuroscience community… each scientific nugget… may open a door in the
prevention effort”.

3.In
Child Development Perspectives (2016,
Vol. 10 [4], 251-256), Philip Fisher and his co-authors have an article with
the title “Promoting healthy child development via a two-generation
translational neuroscience framework: The Filming Interactions to Nurture
Development video coaching program”. This very helpful-sounding program for
parents and young children uses videotaped interactions between the two to
teach parents to pay attention to a child’s communications, to monitor and
reflect on their own behavior, and to wait for children to respond rather than
moving on impatiently. All good goals, and very much in line with recent
efforts to help foster good parent-child relationships—but where did the translational
neuroscience actually come into this program? Did neuroscience help the authors
decide how to shape their program, or did they create a program that did the
things we think are good for behavioral reasons, and then seek a neuroscience
context to strengthen their argument?

4.If
anyone wants more examples, just think about things like teaching to one side
or the other of the brain, patterning, the “cross-crawl”, and dozens of other
claims that a method has specific effects on the brain.

Let’s look at some of the
assumptions that these examples share (and remember the old saying, ASSUME
makes an ASS of U and ME).

One is that behavior and mental abilities are
directly related to brain structures and functions. Of course, this is true at
the coarsest level. Damage the visual areas of the cortex and you don’t see.
Damage the frontal lobes and you don’t plan or anticipate well. But in fact
brains have a lot of redundancy and can do many things in more than one
way—even the person with damage to the visual cortex may be able to walk around
an object in his path, although he is not aware of seeing it. People’s brains
are not all just alike, with most people having the left hemisphere dominant
and a smaller number having the right hemisphere—yet right- and left-handed
people can do most cognitive tasks equally well, as can men and women, whose
brains have some differences.

A second assumption is
that we actually have quite a clear idea of how parts of normal. human brains work. In fact,
neuroimaging gives us only a glimpse into what is happening in the specific
parts of the brain we choose to look at, at a particular time. Most of what we know about connections
between different parts of the brain still involves what has been studied by
autopsy in individuals whose brains have been damaged during life. And, of
course, we have the problem that some of the evidence put forward as explaining
human brain functioning actually comes from information chosen from a variety
of animals and not confirmed by human studies (see http://childmyths.blogspot.com/2014/04/disorderly-thinking-about-developmental.html).

A third assumption, and a
very tenuous one, is that we know what experiences are problems from brain
development, and that we can treat those problems with appropriate
interventions, reverse the effects, correct the brain’s characteristics, and
end up with desirable behaviors (Cf. the first assumption, above). This assumption
seems to avoid the possibility that we could identify experiences that put a
child at risk, intervene successfully, and have a desirable behavioral
outcome—without having any measurable effect on the brain at all!

I am not in the least
trying to claim that human brain functioning is not an important and most
interesting topic of study. Of course it is. But to assume that we know all
about the brain, understand how brain events cause or are caused by experiences,
and have interventions (other than surgery and drugs) that “fix” brains—no,
none of those are true.

So why do people bring neuroscience into
discussions where no relevant information exists? The forthcoming book by David
Wastell and Sue White, Blinded by science,
will focus on this and similar issues and should be well worth reading. From my
own perspective, I would say that today neuroscience is not only a discipline,
but a rhetorical device. Whatever people would like to argue for in child
welfare and related fields, they feel their arguments are stronger if
neuroscience is invoked. And on the whole we let them get away with this; we
don’t challenge their statements and ask what the one thing has to do with the
other. To do so would for many of us open the door to a humiliating loss of face,
as others whisper, “she doesn’t know how important neuroscience is!” If this
happens in the context of professional work, it could mean loss of a job.

But perhaps we need to
learn to tolerate this discomfort and question whether or not the neuroscientific
emperor is wearing clothes. This may especially be the case when practical
decisions are being made about children, as in my Norwegian correspondent’s
concern about child placement. In the
situation he mentioned, the argument appears to be: “This child was maltreated
and neglected. Therefore, his brain is damaged. If a parent struck a child in
the head with a brick and damaged his brain, we would terminate the parent’s
rights. Brain damage is brain damage, so the brain damage resulting from
neglect or verbal abuse is the same as that resulting from the brick, and the
response should be the same.” Can anyone step forward and say, “Wait one
minute. What evidence do you have that this child’s brain is damaged in any
meaningful sense? And what can you say about the outcomes for the child if this
parent is helped to improve his or her parenting skills, as compared to what
will happen if the child enters the foster care system?” To make the best
choice for the child, we may have to abandon the easy and fashionable
neuroscience rhetoric, with its scary conflation of head trauma and the
problematic (but very different) effects of neglect and poor parenting.

I admit, though, that few
can step forward in this way, because the practical consequences of getting “out
of step” may be quite severe.

4 comments:

Thanks, Jean, for sticking your neck out to make these comments. I find myself, as an Educational Psychologist in the UK, having to make arguments along this line on a weekly basis, in order to counteract various neuromyths that have taken hold within schools and other child support services (in particular in relation to very early experiences). I was struck by the overlap between some of your comments, and the opening arguments of a recent book called "Neuroscience in Education: The Good, The Bad and The Ugly" by Mike Anderson and Sergio Della Sala. The 'good', 'bad' and 'ugly' of the title, relate to various attempts to bridge between education and neuroscience in more or less effective ways.

On the opening page, they make a similar point to yours, but using 'cognition' rather than 'behaviour' reflecting their focus on educational contexts - to quote them: "...the first and most important lesson we have learned in putting the book together is that while the use of the term 'neuroscience' is attractive for education it seems to us that it is cognitive psychology that does all the useful work or 'heavy lifting'. The reason for this is straightforward. We believe that for educators, research indicating that one form of learning is more efficient than another is more relevant than knowing where in the brain that learning happens. There is indeed a gap between neuroscience and education. But that gap is not filled by the 'interaction' of neuroscientists and teachers (nearly always constituted by the former patronizing the latter) or 'bridging' the two fields by training teachers in basic neuroscience and having neuroscientists as active participators in educating children. Rather what will ultimately fill the gap is the development of evidence-based education where that base is cognitive psychology."

Thanks so much for your comments. I know I am far from the first to say these things. The U.S. educational psychologist Daniel Willingham has for years been fighting "neurofads" like the idea of learning styles or of left- and right-brain learners. But as it so often happens, bad ideas continue to drive out good ones. I wrote the post because I was really concerned by recent work in which some sort of nod to neuroscience seems to be intended to take the place of evidence-- especially the whole Schore-Perry-van der Kolk school of brain damage.

As for cognition and behavior, of course the allegations about cognition are of enormous practical importance and really should receive critical attention rather than becoming the latest educational fad. I just focused on behavior because the topics I was dealing with had more emphasis on mood and behavior. But-- evidence-based education-- what a fantasy it remains! (And while it stays a fantasy, people in other fields are busily trying to weaken what is meant by an evidence basis, and those efforts will no doubt delay EB educational planning.)

Another excellent recent book covering similar themes, written by a microbiologist and a sociologist of science, Hilary and Steven Rose, is "Can neuroscience change our minds?"http://eu.wiley.com/WileyCDA/WileyTitle/productCd-0745689329.html

About Me https://en.wikipedia.org/wiki/Jean_Mercer

Jean Mercer has a Ph.D in Psychology from Brandeis University, earned when that institution was 20 years old (you do the math). She is Professor Emerita of Psychology at Richard Stockton College, where for many years she taught developmental psychology, research methods, perception, and history of psychology. Since about 2000 her focus has been on potentially dangerous child psychotherapies, and she has published several related books and a number of articles in professional journals.
Her CV can be seen at http://childmyths.blogspot.com/2009/12/curriculum-vitae-jean.mercer-richard.html.